A case report of Ggeneralized uterine arteriovenous malformation after molar pregnancy in an infertile woman

Abstract

Background:Uterine arteriovenous malformation (UAVM) is a rare vascular condition in reproductive age presented mostly with bleeding. Although this malformation is infrequent, it is potentially life-threatening. Transvaginal Doppler ultrasonography is a widely available, noninvasive and excellent diagnostic method.Case:The case is a 30-yr-old woman with a history of eight-yr infertility.following intrauterine insemination treatment, she had a molar pregnancy. Despite methotrexate treatment, there was persistent vaginal bleeding. Assessment of this patient was done with transvaginal sonography and color Doppler. According to suspicious appearances, angiography was planned for confirmation of UAVM.Conclusion:UAVM is one of the molar pregnancy complications. The first step for diagnosis of UAVM is transvaginal ultrasonography and color Doppler assessment. Embolization is the best treatment for women who intend to preserve fertility.

Uterine Arteriovenous Malformation: A Pictorial Review of Diagnosis and Management

“…Several studies prospectively evaluate the incidence of uterine vascular malformations, including UAVMs, developing after abortion or delivery by using transvaginal color Doppler ultrasound (US). 18,19 There is little information about the frequency of these lesions in the literature. UAVMs make up about 1% to 2% of all genital and intraperitoneal hemorrhages.…”

“…9,51,52 Findings on physical examination such as palpation of abnormally dilated vessels in the vagina, a bulky pulsatile uterus, or pulsating mass in the adnexal area can aid in an accurate diagnosis. 19,53 Injury, biopsy, infection, thrombosis, puberty, and pregnancy can cause an acute increase in severity or flare-ups. Rarely, very high flow damage causes high flow heart failure in early childhood.…”

“…The radiological features are summarized in Table 1. 2,19,25,[54][55][56][57][58][59][60][61][62] Table 1. Common Imaging Findings of Uterine Arteriovenous Malformation (UAVM).…”

“…Common Imaging Findings of Uterine Arteriovenous Malformation (UAVM). 2,19,25,[54][55][56][57][58][59][60][61][62]…”

“…MRA with 3-dimensional (3D) and dynamic pulse sequences with multiplane reconstruction and timing resolution play an important role in the evaluation of UAVMs (Figures 7-11). 19,[58][59][60]…”